Andrea B. Goldschmidt, Kwonho Jeong, Lan Yu, Amy H. Egbert, Ricarda Schmidt, Anja Hilbert
{"title":"接受认知行为疗法治疗暴饮暴食症的青少年的执行功能和治疗效果","authors":"Andrea B. Goldschmidt, Kwonho Jeong, Lan Yu, Amy H. Egbert, Ricarda Schmidt, Anja Hilbert","doi":"10.1111/jcpp.14031","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Background</h3>\n \n <p>Cognitive-behavioral therapy (CBT) is an evidence-supported treatment for adolescents with binge-eating disorder (BED). Executive dysfunctions, which are associated with binge eating and elevated body weight in youth, may undermine CBT outcomes by making it difficult for youth to engage with or adhere to treatment, including recalling and/or implementing intervention strategies in real-world contexts.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We assessed 73 adolescents [82.2% female; <i>M</i><sub>age</sub> = 15.0 ± 2.5 year; <i>M</i> baseline standardized body mass index (zBMI) = 1.9 ± 1.0 kg/m<sup>2</sup>] with BED at baseline, posttreatment, 6-, 12-, and 24-month follow-up. Linear mixed models examined the effects of baseline executive functioning (EF) on loss of control (LOC) eating and weight change following CBT. Linear and logistic regressions probed associations between EF, attendance, and attrition.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>More impulsive decision-making, as reflected in higher baseline scores on the Iowa Gambling Task, predicted better attendance (<i>β</i> = .07; <i>p</i> = .019) and more frequent LOC eating following treatment (<i>β</i> = .12; <i>p</i> = .017). Lower cognitive flexibility, as reflected in lower baseline <i>T</i>-scores on the Comprehensive Trail Making Test complex sequencing index, predicted higher zBMI following treatment (<i>β</i> = −.03; <i>p</i> = .003). Inhibition, concentration, attention, and parent-reported EF behavior symptoms were not associated with outcome, attendance, or attrition.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>More impulsive decision-making and lower cognitive flexibility were associated with suboptimal response to CBT for BED, although findings should be interpreted with caution in light of the sample size and waitlist control design. Future research should examine whether strengthening EF could improve eating and weight outcomes among adolescents with BED who have lower pre-treatment EF.</p>\n </section>\n </div>","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"66 1","pages":"64-74"},"PeriodicalIF":6.5000,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14031","citationCount":"0","resultStr":"{\"title\":\"Executive functioning and treatment outcome among adolescents undergoing cognitive-behavioral therapy for binge-eating disorder\",\"authors\":\"Andrea B. Goldschmidt, Kwonho Jeong, Lan Yu, Amy H. Egbert, Ricarda Schmidt, Anja Hilbert\",\"doi\":\"10.1111/jcpp.14031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Cognitive-behavioral therapy (CBT) is an evidence-supported treatment for adolescents with binge-eating disorder (BED). Executive dysfunctions, which are associated with binge eating and elevated body weight in youth, may undermine CBT outcomes by making it difficult for youth to engage with or adhere to treatment, including recalling and/or implementing intervention strategies in real-world contexts.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We assessed 73 adolescents [82.2% female; <i>M</i><sub>age</sub> = 15.0 ± 2.5 year; <i>M</i> baseline standardized body mass index (zBMI) = 1.9 ± 1.0 kg/m<sup>2</sup>] with BED at baseline, posttreatment, 6-, 12-, and 24-month follow-up. Linear mixed models examined the effects of baseline executive functioning (EF) on loss of control (LOC) eating and weight change following CBT. Linear and logistic regressions probed associations between EF, attendance, and attrition.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>More impulsive decision-making, as reflected in higher baseline scores on the Iowa Gambling Task, predicted better attendance (<i>β</i> = .07; <i>p</i> = .019) and more frequent LOC eating following treatment (<i>β</i> = .12; <i>p</i> = .017). Lower cognitive flexibility, as reflected in lower baseline <i>T</i>-scores on the Comprehensive Trail Making Test complex sequencing index, predicted higher zBMI following treatment (<i>β</i> = −.03; <i>p</i> = .003). Inhibition, concentration, attention, and parent-reported EF behavior symptoms were not associated with outcome, attendance, or attrition.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>More impulsive decision-making and lower cognitive flexibility were associated with suboptimal response to CBT for BED, although findings should be interpreted with caution in light of the sample size and waitlist control design. Future research should examine whether strengthening EF could improve eating and weight outcomes among adolescents with BED who have lower pre-treatment EF.</p>\\n </section>\\n </div>\",\"PeriodicalId\":187,\"journal\":{\"name\":\"Journal of Child Psychology and Psychiatry\",\"volume\":\"66 1\",\"pages\":\"64-74\"},\"PeriodicalIF\":6.5000,\"publicationDate\":\"2024-06-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpp.14031\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Child Psychology and Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jcpp.14031\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Child Psychology and Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jcpp.14031","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Executive functioning and treatment outcome among adolescents undergoing cognitive-behavioral therapy for binge-eating disorder
Background
Cognitive-behavioral therapy (CBT) is an evidence-supported treatment for adolescents with binge-eating disorder (BED). Executive dysfunctions, which are associated with binge eating and elevated body weight in youth, may undermine CBT outcomes by making it difficult for youth to engage with or adhere to treatment, including recalling and/or implementing intervention strategies in real-world contexts.
Methods
We assessed 73 adolescents [82.2% female; Mage = 15.0 ± 2.5 year; M baseline standardized body mass index (zBMI) = 1.9 ± 1.0 kg/m2] with BED at baseline, posttreatment, 6-, 12-, and 24-month follow-up. Linear mixed models examined the effects of baseline executive functioning (EF) on loss of control (LOC) eating and weight change following CBT. Linear and logistic regressions probed associations between EF, attendance, and attrition.
Results
More impulsive decision-making, as reflected in higher baseline scores on the Iowa Gambling Task, predicted better attendance (β = .07; p = .019) and more frequent LOC eating following treatment (β = .12; p = .017). Lower cognitive flexibility, as reflected in lower baseline T-scores on the Comprehensive Trail Making Test complex sequencing index, predicted higher zBMI following treatment (β = −.03; p = .003). Inhibition, concentration, attention, and parent-reported EF behavior symptoms were not associated with outcome, attendance, or attrition.
Conclusions
More impulsive decision-making and lower cognitive flexibility were associated with suboptimal response to CBT for BED, although findings should be interpreted with caution in light of the sample size and waitlist control design. Future research should examine whether strengthening EF could improve eating and weight outcomes among adolescents with BED who have lower pre-treatment EF.
期刊介绍：
The Journal of Child Psychology and Psychiatry (JCPP) is a highly regarded international publication that focuses on the fields of child and adolescent psychology and psychiatry. It is recognized for publishing top-tier, clinically relevant research across various disciplines related to these areas. JCPP has a broad global readership and covers a diverse range of topics, including:
Epidemiology: Studies on the prevalence and distribution of mental health issues in children and adolescents.
Diagnosis: Research on the identification and classification of childhood disorders.
Treatments: Psychotherapeutic and psychopharmacological interventions for child and adolescent mental health.
Behavior and Cognition: Studies on the behavioral and cognitive aspects of childhood disorders.
Neuroscience and Neurobiology: Research on the neural and biological underpinnings of child mental health.
Genetics: Genetic factors contributing to the development of childhood disorders.
JCPP serves as a platform for integrating empirical research, clinical studies, and high-quality reviews from diverse perspectives, theoretical viewpoints, and disciplines. This interdisciplinary approach is a key feature of the journal, as it fosters a comprehensive understanding of child and adolescent mental health.
The Journal of Child Psychology and Psychiatry is published 12 times a year and is affiliated with the Association for Child and Adolescent Mental Health (ACAMH), which supports the journal's mission to advance knowledge and practice in the field of child and adolescent mental health.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
